Bottom Line:
Repeat visits to an emergency department (ED) within a short period of time for recurring or continuing abdominal pain should make physicians suspicious for relapsing or episodic disease processes.I present a case of a 17-year-old female with cecal volvulus found only after multiple ED visits.

ABSTRACTRepeat visits to an emergency department (ED) within a short period of time for recurring or continuing abdominal pain should make physicians suspicious for relapsing or episodic disease processes. I present a case of a 17-year-old female with cecal volvulus found only after multiple ED visits.

f2-wjem-11-202: Repeat computed tomography scan showed marked dilatation (arrow) of the cecum up to 10.5 cm with a transition point in the right lower quadrant suspicious for obstruction and cecal volvulus.

Mentions:
The patient returned to the ED 27 hours after the second visit reporting severe abdominal pain in the right lower quadrant, nausea, vomiting, and no bowel movement in four days. Her abdominal exam revealed decreased bowel sounds, distention and tenderness in the right lower quadrant with voluntary guarding. WBC was elevated (13.6) and a repeat CT showed marked dilatation of the cecum up to 10.5 cm with a transition point in the right lower quadrant suspicious for obstruction and cecal volvulus (Figure 2).

f2-wjem-11-202: Repeat computed tomography scan showed marked dilatation (arrow) of the cecum up to 10.5 cm with a transition point in the right lower quadrant suspicious for obstruction and cecal volvulus.

Mentions:
The patient returned to the ED 27 hours after the second visit reporting severe abdominal pain in the right lower quadrant, nausea, vomiting, and no bowel movement in four days. Her abdominal exam revealed decreased bowel sounds, distention and tenderness in the right lower quadrant with voluntary guarding. WBC was elevated (13.6) and a repeat CT showed marked dilatation of the cecum up to 10.5 cm with a transition point in the right lower quadrant suspicious for obstruction and cecal volvulus (Figure 2).

Bottom Line:
Repeat visits to an emergency department (ED) within a short period of time for recurring or continuing abdominal pain should make physicians suspicious for relapsing or episodic disease processes.I present a case of a 17-year-old female with cecal volvulus found only after multiple ED visits.

ABSTRACTRepeat visits to an emergency department (ED) within a short period of time for recurring or continuing abdominal pain should make physicians suspicious for relapsing or episodic disease processes. I present a case of a 17-year-old female with cecal volvulus found only after multiple ED visits.